| NPI | 1073956942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CO DR.0062687) |
| Additional Taxonomies | 208800000X Urology (Licence: CO TL 0004631) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2019-08-20 |