| NPI | 1821158437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101031810) |
| Additional Taxonomies | 208800000X Urology (Licence: MD D25669) |
| 208800000X Urology (Licence: DC MD33129) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2011-11-02 |