| NPI | 1083659007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101040054) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 31041) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2013-11-27 |