| NPI | 1922205186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: AZ 50653) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 201200193) |
| 208800000X Urology (Licence: KS 6848) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2020-06-07 |