| NPI | 1124051248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: LA MD.204640) |
| Additional Taxonomies | 208800000X Urology (Licence: MS 19100) |
| 208800000X Urology (Licence: FL ME104163) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2015-10-23 |