| NPI | 1720013204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: ME MD20256) |
| Additional Taxonomies | 208800000X Urology (Licence: WA MD00027077) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2017-05-16 |