| NPI | 1386868693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME24898) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME24898) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2016-04-15 |