| NPI | 1174570154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME116870) |
| Additional Taxonomies | 208800000X Urology (Licence: MD D62092) |
| 208800000X Urology (Licence: CA C53670) | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2013-07-11 |