| NPI | 1609853613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME29625) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME29625) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2014-06-20 |