| NPI | 1639111321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35.037034) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35037034) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2011-07-15 |