| NPI | 1003829201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME122147) |
| Additional Taxonomies | 208800000X Urology (Licence: MI RB047140) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2022-10-28 |