| NPI | 1891808028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AZ 35699) |
| Additional Taxonomies | 208800000X Urology (Licence: AZ 35699) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2021-12-22 |