| NPI | 1699977744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: RI CMD14133) |
| Additional Taxonomies | 208600000X Surgery (Licence: RI LP01080) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2013-01-21 |