| NPI | 1114980315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME53218) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME0053218) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2021-07-30 |