| NPI | 1245249044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: KS 04-34552) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2010024966) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2019-09-04 |