| NPI | 1003090382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CO 0056872) |
| Additional Taxonomies | 208800000X Urology (Licence: FL ME101754) |
| Enumeration Date | 2007-12-22 |
| Last Update Date | 2017-01-06 |