| NPI | 1699828400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35.095471) |
| Additional Taxonomies | 208800000X Urology (Licence: LA 201215) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-11-30 |