| NPI | 1356325674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35.140177) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301054366) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2020-07-17 |