| NPI | 1013166990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: SC 83826) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2013019928) |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2020-08-12 |