| NPI | 1003873050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: AR E-4543) |
| Additional Taxonomies | 208800000X Urology (Licence: UT 5276300-1205) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2018-01-29 |