| NPI | 1508080664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: LA MD.204077) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MT186776) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2014-12-11 |