| NPI | 1265477376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: TX F3915) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX F3915) |
| 208800000X Urology (Licence: NH 15148) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2014-08-11 |