| NPI | 1275552655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: MI 4301404448) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301404448) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2017-09-21 |