| NPI | 1366403800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2005037432) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO 2005037432) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2020-09-01 |