| NPI | 1932318243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MS 21716) |
| Additional Taxonomies | 208800000X Urology (Licence: SC TL33026) |
| 208800000X Urology (Licence: LA 205946) | |
| 208800000X Urology (Licence: VA 0101250371) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2013-04-01 |