| NPI | 1962611905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2007-00807) |
| Additional Taxonomies | 208800000X Urology (Licence: CO DR.0067448) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2023-04-05 |