| NPI | 1134439086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX Q5134) |
| Additional Taxonomies | 208800000X Urology (Licence: CT 55336) |
| 208600000X Surgery (Licence: TX BP 10036843) | |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2018-08-15 |