| NPI | 1821041476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: GA 052226) |
| Additional Taxonomies | 208800000X Urology (Licence: AL 26713) |
| 208800000X Urology (Licence: NC 2010-01013) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2017-03-16 |