| NPI | 1821086927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101253406) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 28785) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2020-07-17 |