| NPI | 1962480624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME84135) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME84135) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2014-06-20 |