| NPI | 1336403260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: AL 35901) |
| Additional Taxonomies | 208800000X Urology (Licence: NV 17981) |
| 208800000X Urology (Licence: GA 005527) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2018-06-22 |