| NPI | 1871766162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2017001966) |
| Additional Taxonomies | 208800000X Urology (Licence: WI 53818-20) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2017-05-01 |