| NPI | 1639178551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD041200E) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD041200E) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2011-05-31 |