| NPI | 1902077332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CO 47409) |
| Additional Taxonomies | 208800000X Urology (Licence: TX M9361) |
| 208800000X Urology (Licence: TX BP30019030) | |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2009-09-01 |