| NPI | 1598015125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35.133816) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301101388) |
| 208800000X Urology (Licence: FL ME130272) | |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2021-01-14 |