| NPI | 1982622353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME158380) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 35060981) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2023-02-01 |