| NPI | 1497904205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35.096397) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301093216) |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2018-03-14 |