| NPI | 1457338527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX D8202) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX D8202) |
| 208800000X Urology (Licence: CO DR-38516) | |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2015-03-11 |