| NPI | 1861740185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME104960) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME 104960) |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2017-11-21 |