| NPI | 1346240827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101240640) |
| Additional Taxonomies | 208800000X Urology (Licence: FL ME83855) |
| Enumeration Date | 2005-07-27 |
| Last Update Date | 2020-10-28 |