| NPI | 1023011517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VT 0420010146) |
| Additional Taxonomies | 208800000X Urology (Licence: IA 26588) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2014-11-19 |