| NPI | 1952541690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OK 33438) |
| Additional Taxonomies | 208800000X Urology (Licence: ND 12441) |
| 208800000X Urology (Licence: CA A105404) | |
| Enumeration Date | 2009-02-20 |
| Last Update Date | 2021-01-01 |