| NPI | 1033201181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MT 5350) |
| Additional Taxonomies | 208800000X Urology (Licence: UT 1697521205) |
| 208800000X Urology (Licence: WY 3895A) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2007-07-08 |