| NPI | 1205060175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: LA 307858) |
| Additional Taxonomies | 208800000X Urology (Licence: TX 10033777) |
| 208800000X Urology (Licence: TX Q3854) | |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2018-03-17 |