| NPI | 1053365767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME108495) |
| Additional Taxonomies | 208800000X Urology (Licence: MD D62856) |
| 208800000X Urology (Licence: TX m3052) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2011-08-29 |