| NPI | 1871749424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD449537) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO bb4575875-2008018150) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2013-09-25 |