| NPI | 1861474439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 200001545) |
| Additional Taxonomies | 208800000X Urology (Licence: TN DO0000002787) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2020-12-03 |