| NPI | 1649382417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OR MD152794) |
| Additional Taxonomies | 208800000X Urology (Licence: WA ML20008500) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-11-05 |