| NPI | 1396726394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2007-01720) |
| Additional Taxonomies | 208800000X Urology (Licence: FL ME81837) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2021-03-08 |