| NPI | 1043416506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL OS10348) |
| Additional Taxonomies | 208800000X Urology (Licence: PA 0s013305) |
| 208800000X Urology (Licence: WV 2603) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2014-01-27 |