| NPI | 1972783512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 121872) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 200900171) |
| Enumeration Date | 2007-11-12 |
| Last Update Date | 2021-08-18 |