| NPI | 1457322422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WI 51267-020) |
| Additional Taxonomies | 208800000X Urology (Licence: AZ 27199) |
| 208800000X Urology (Licence: MN 53347) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2015-09-14 |