| NPI | 1447238373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA MD61394213) |
| Additional Taxonomies | 208800000X Urology (Licence: MN 30338) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2024-08-23 |