| NPI | 1669439048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NV 19244) |
| Additional Taxonomies | 208800000X Urology (Licence: NV 2945) |
| 208800000X Urology (Licence: AZ 37557) | |
| 208800000X Urology (Licence: CA G21289) | |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2019-09-11 |