| NPI | 1407835440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX J2954) |
| Additional Taxonomies | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: TX J2954) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2020-11-13 |