| NPI | 1104816131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35088520) |
| Additional Taxonomies | 208800000X Urology (Licence: KS 04-29272) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2022-01-25 |