| NPI | 1740251149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101044087) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 38995) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2012-02-13 |