| NPI | 1033227426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MA 253715) |
| Additional Taxonomies | 208800000X Urology (Licence: NH RT1178) |
| 208800000X Urology (Licence: ME 018468) | |
| Enumeration Date | 2006-08-27 |
| Last Update Date | 2012-11-19 |