| NPI | 1861565624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: AL MD.31014) |
| Additional Taxonomies | 208800000X Urology (Licence: FL TRN10140) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2011-08-12 |