| NPI | 1679769491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MS 20832) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301095875) |
| Enumeration Date | 2007-09-16 |
| Last Update Date | 2014-01-08 |