| NPI | 1215084017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X (Licence: UT 6513463-1205) |
| Additional Taxonomies | 208800000X Urology (Licence: UT 6513463-1205) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2017-12-05 |