| NPI | 1851319362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: GA 029101) |
| Additional Taxonomies | 208800000X Urology (Licence: LA 15369R) |
| 208800000X Urology (Licence: LA MD15369R) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2012-12-07 |