| NPI | 1366415408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD058374L) |
| Additional Taxonomies | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: PA MD058374) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2008-07-31 |