| NPI | 1831299726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 067062) |
| Additional Taxonomies | 208800000X Urology (Licence: AR E-4785) |
| 208800000X Urology (Licence: OH 35.094639) | |
| 208800000X Urology (Licence: GA 067062) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2013-10-04 |