| NPI | 1760417612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MS 07141) |
| Additional Taxonomies | 208800000X Urology (Licence: AL MD.8123) |
| 208800000X Urology (Licence: LA MD.011742) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2017-12-05 |