| NPI | 1134121155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35.030194) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 030194) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2017-04-11 |