| NPI | 1750356663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 102732) |
| Additional Taxonomies | 208800000X Urology (Licence: KS 0424419) |
| 208800000X Urology (Licence: KY 26727) | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2016-10-12 |