| NPI | 1225024342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WV 20833) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0101232558) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2020-09-18 |