| NPI | 1578531828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X (Licence: TX R0052) |
| Additional Taxonomies | 208800000X Urology (Licence: OK 19716) |
| 2088P0231X (Licence: OK 19716) | |
| Enumeration Date | 2006-03-12 |
| Last Update Date | 2016-10-06 |