| NPI | 1821321472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME43472) |
| Additional Taxonomies | 208800000X Urology (Licence: FL ME43472) |
| Enumeration Date | 2009-09-15 |
| Last Update Date | 2009-09-15 |