| NPI | 1548261860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: KS 04-31784) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2008025048) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2018-03-17 |