| NPI | 1205875556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX N5643) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0101230802) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2011-03-12 |