| NPI | 1538365861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD444180) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301084381) |
| Enumeration Date | 2007-06-24 |
| Last Update Date | 2020-08-10 |