| NPI | 1518051481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: ME 018614) |
| Additional Taxonomies | 208800000X Urology (Licence: VT 042-0008456) |
| 208800000X Urology (Licence: NH 8746) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2012-12-20 |