| NPI | 1043223480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 23578) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 23578) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2011-02-10 |