| NPI | 1629093604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101047783) |
| Additional Taxonomies | 208800000X Urology (Licence: CA G87457) |
| 208800000X Urology (Licence: KS 04-39757) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2020-01-20 |