| NPI | 1629009089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME0082623) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME0082623) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2015-09-29 |