| NPI | 1942259908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME100187) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 35085793) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2020-12-16 |