| NPI | 1942280706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: FL 0014272) |
| Additional Taxonomies | 208800000X Urology (Licence: FL ME0014272) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2013-06-03 |