| NPI | 1467893404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: SC 40956) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0116025108) |
| Enumeration Date | 2013-07-06 |
| Last Update Date | 2018-04-17 |