| NPI | 1679578587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: VA 0101032283) |
| Additional Taxonomies | 208800000X Urology (Licence: CO DR0063085) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2019-09-20 |