| NPI | 1427238153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2009-01119) |
| Additional Taxonomies | 208800000X Urology (Licence: LA MD.200801) |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2021-04-01 |