| NPI | 1417065848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OR MD09630) |
| Additional Taxonomies | 208800000X Urology (Licence: WA MD00034648) |
| Enumeration Date | 2006-08-27 |
| Last Update Date | 2012-10-16 |