| NPI | 1841290392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MS 12474) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 21456) |
| Enumeration Date | 2005-07-27 |
| Last Update Date | 2018-03-17 |