| NPI | 1366545394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OR MD15065) |
| Additional Taxonomies | 208800000X Urology (Licence: WA MD00034524) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2007-07-08 |