| NPI | 1841339884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA MD60132109) |
| Additional Taxonomies | 208800000X Urology (Licence: NM 2004-0149) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2013-04-23 |