| NPI | 1972009306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WI 81648) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 29580) |
| 208800000X Urology (Licence: MN 29580) | |
| 208800000X Urology (Licence: MN 65857) | |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2023-07-19 |