| NPI | 1740268978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX L0785) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0101053580) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2011-11-11 |