| NPI | 1225092794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VT 042-0012170) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0101 033452) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2011-09-12 |