| NPI | 1659500890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X (Licence: AZ 57239) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A127291) |
| 2088P0231X (Licence: CA A127291) | |
| 2088P0231X (Licence: FL ME128237) | |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2018-12-18 |