| NPI | 1154365625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WI 40161-20) |
| Additional Taxonomies | 208800000X Urology (Licence: WI 40161-020) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2015-01-27 |