| NPI | 1093795429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2008-01525) |
| Additional Taxonomies | 208800000X Urology (Licence: MN 47942) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2008-08-27 |