| NPI | 1598731267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: KS 5568) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2002010590) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2018-04-17 |