| NPI | 1437143187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME0032413) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: FL ME32413) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2012-10-15 |