| NPI | 1669551479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PR 5355) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A36841) |
| 208800000X Urology (Licence: FL ME50601) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2007-07-08 |