| NPI | 1982809141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: AZ 60257) |
| Additional Taxonomies | 208800000X Urology (Licence: HI 14345) |
| 208800000X Urology (Licence: FL ME113629) | |
| 208800000X Urology (Licence: TX P3011) | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2023-05-02 |