| NPI | 1356300552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101243073) |
| Additional Taxonomies | 208800000X Urology (Licence: AZ 30046) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2008-08-05 |