| NPI | 1811145212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: KS 0440636) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 35.096110) |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2018-03-17 |