| NPI | 1891804696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME106726) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 35089293) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2017-04-25 |