| NPI | 1487630968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: ID M-6391) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: ID M-6391) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2015-10-14 |