| NPI | 1972942035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2018012019) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2013018114) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2018-06-27 |