| NPI | 1295058394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101249728) |
| Additional Taxonomies | 208800000X Urology (Licence: TX N1955) |
| Enumeration Date | 2010-03-04 |
| Last Update Date | 2013-11-27 |