| NPI | 1700863727 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208800000X Urology (Licence: FL ME64022) | 
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME64022) | 
| Enumeration Date | 2005-12-30 | 
| Last Update Date | 2014-06-20 |