| NPI | 1487844668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: LA MD.202008) |
| Additional Taxonomies | 208D00000X General Practice (Licence: LA MD.202008) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2021-11-25 |