| NPI | 1780648220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME0080333) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL : ME80333) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2016-05-02 |