| NPI | 1942288394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX H4250) |
| Additional Taxonomies | 208800000X Urology (Licence: TX 208800000-urology) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2012-02-13 |