| NPI | 1114157609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MN 60557) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2014012624) |
| 208800000X Urology (Licence: WI 55268) | |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2020-09-30 |