| NPI | 1386643682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: LA MD.05067R) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 05067R) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2014-11-05 |