| NPI | 1235164286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TN 26045) |
| Additional Taxonomies | 208800000X Urology (Licence: TN MD0000026045) |
| 208800000X Urology (Licence: MO 119325) | |
| 208800000X Urology (Licence: MS 22564) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2013-07-25 |