| NPI | 1962713677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL OS18465) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0102202800) |
| 208800000X Urology (Licence: GA 84401) | |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2022-08-11 |