| NPI | 1740400316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CO 51360) |
| Additional Taxonomies | 208800000X Urology (Licence: MN 49741) |
| 208800000X Urology (Licence: OH 35.097122) | |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2013-06-11 |