| NPI | 1578728200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MA 254821) |
| Additional Taxonomies | 208600000X Surgery (Licence: OR LL17193) |
| 208800000X Urology (Licence: OR LL17193) | |
| 208800000X Urology (Licence: NH 16204) | |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2017-04-06 |