| NPI | 1710924204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MI 4301039423) |
| Additional Taxonomies | 208800000X Urology (Licence: VT 042.0013197) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2015-07-14 |