| NPI | 1124110275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NH 15955) |
| Additional Taxonomies | 208800000X Urology (Licence: MT 8217) |
| 208800000X Urology (Licence: WY 6858A) | |
| 2088P0231X (Licence: NH 15955) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2013-01-07 |