| NPI | 1154565273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WI 19702) |
| Additional Taxonomies | 208800000X Urology (Licence: UT 7223921-1205) |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2018-09-12 |