| NPI | 1396764197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD015799E) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PA PAK000141) |
| 208800000X Urology (Licence: PA MD-015799-E) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2014-07-08 |