| NPI | 1376518670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 010153797) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101053797) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2013-12-03 |