| NPI | 1316010606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: ME 016102) |
| Additional Taxonomies | 174400000X Specialist (Licence: VT 0420006166) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2010-07-09 |