| NPI | 1356329437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 200700289) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0101020668) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2014-02-11 |