| NPI | 1679744205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME 125170) |
| Additional Taxonomies | 208800000X Urology (Licence: HI MD-17654) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2018-11-05 |