| NPI | 1992459655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VT 042.0017875) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 35.143580) |
| Enumeration Date | 2022-02-10 |
| Last Update Date | 2025-01-02 |