| NPI | 1285922187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MI 4301099329) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301099329) |
| 208800000X Urology (Licence: MI 4301099329) | |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2018-08-17 |