| NPI | 1861712671 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: KS 04-39022) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2500033725) |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2021-01-18 |