| NPI | 1740301654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: SC 81577) |
| Additional Taxonomies | 208800000X Urology (Licence: KS 6693) |
| 208800000X Urology (Licence: MI 4301103516) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2018-09-19 |