| NPI | 1497731343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101270400) |
| Additional Taxonomies | 208800000X Urology (Licence: FL ME86658) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2020-09-28 |