| NPI | 1194153825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WV 28042) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301099931) |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2018-03-17 |