| NPI | 1922191568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: DE C1-0010849) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 170576-1) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2015-12-02 |