| NPI | 1962592873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NE 24563) |
| Additional Taxonomies | 208600000X Surgery (Licence: KY 40187) |
| 208600000X Surgery (Licence: NE 24563) | |
| 208800000X Urology (Licence: KY 40187) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2025-03-31 |