| NPI | 1982051330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: KY 58626) |
| Additional Taxonomies | 208800000X Urology (Licence: KY TP732) |
| 208800000X Urology (Licence: NC 219511) | |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2023-10-25 |