| NPI | 1487618484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101265973) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 35076542J) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2020-11-12 |