| NPI | 1992200984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME175272) |
| Additional Taxonomies | 208800000X Urology (Licence: GA 110046) |
| 208800000X Urology (Licence: MD D96925) | |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2026-06-01 |