| NPI | 1003875899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MA 41052) |
| Additional Taxonomies | 208800000X Urology (Licence: NM MD20040514) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2010-06-18 |