| NPI | 1982963864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX R1229) |
| Additional Taxonomies | 208800000X Urology (Licence: TX BP10044571) |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2021-08-25 |