| NPI | 1700102704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX P8603) |
| Additional Taxonomies | 208800000X Urology (Licence: TX BP10034440) |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2016-05-09 |