| NPI | 1518971175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086H0002X Surgery, Hospice and Palliative Medicine (Licence: FL ME11360) |
| Additional Taxonomies | 208800000X Urology (Licence: FL 0011360) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2016-04-18 |