| NPI | 1619069754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CT 036550) |
| Additional Taxonomies | 208800000X Urology (Licence: CT 036550) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2013-05-28 |