| NPI | 1487742201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OR MD28212) |
| Additional Taxonomies | 208800000X Urology (Licence: WA 15152) |
| 208800000X Urology (Licence: AZ 33271) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2015-03-26 |