| NPI | 1851571590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: UT 6012531-1205) |
| Additional Taxonomies | 208800000X Urology (Licence: LA MD.026474) |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2015-08-18 |