| NPI | 1245415454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME126100) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301097056) |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2017-02-16 |