| NPI | 1033186606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: ID M10519) |
| Additional Taxonomies | 208800000X Urology (Licence: WA MD00044961) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2012-09-18 |