| NPI | 1598925331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME115653) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 35.121271) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2015-09-23 |