| NPI | 1245282458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101226594) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 200300128) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2010-11-09 |