| NPI | 1407888316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MS 06768) |
| Additional Taxonomies | 208800000X Urology (Licence: TX 53526E3603) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2010-04-27 |