| NPI | 1982134391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MN 71077) |
| Additional Taxonomies | 208800000X Urology (Licence: WI 22454) |
| 208800000X Urology (Licence: WI 77702) | |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2024-07-09 |