| NPI | 1740213867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2011-00406) |
| Additional Taxonomies | 174400000X Specialist (Licence: CT 044379) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2012-05-08 |