| NPI | 1154494607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NH 9743) |
| Additional Taxonomies | 208800000X Urology (Licence: VT 042-0009870) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2012-03-29 |