| NPI | 1457385072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35-053721) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301072611) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2013-01-09 |