| NPI | 1205834074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2016012292) |
| Additional Taxonomies | 208800000X Urology (Licence: KS 04-33531) |
| 208800000X Urology (Licence: OK 31026) | |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2016-06-16 |