| NPI | 1881658987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME35640) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME35640) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2011-12-09 |