| NPI | 1184696627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2001009167) |
| Additional Taxonomies | 208800000X Urology (Licence: MN 43948) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2011-02-22 |