| NPI | 1982699849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101238539) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101238539) |
| 208800000X Urology (Licence: DE C1-0026775) | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2024-03-21 |