| NPI | 1982661781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MN 60438) |
| Additional Taxonomies | 2088P0231X (Licence: OH 35.144254) |
| 208800000X Urology (Licence: WI 68460) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2024-12-04 |