| NPI | 1033158209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: IA 40582) |
| Additional Taxonomies | 208800000X Urology (Licence: SC 32513) |
| 208800000X Urology (Licence: NC 2008-00739) | |
| 208800000X Urology (Licence: AZ 20134) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2018-03-17 |