| NPI | 1891767745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OR DO154497) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 5101012942) |
| Enumeration Date | 2006-02-05 |
| Last Update Date | 2014-12-09 |