| NPI | 1982760369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME109228) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MT188365) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2014-12-11 |