| NPI | 1710994918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35052402) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD061679L) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2008-06-04 |