| NPI | 1013117092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CO 39885) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO DR.0039885) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2017-02-07 |