| NPI | 1811976855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VT 042.0012709) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0101021068) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2013-09-30 |