| NPI | 1982847703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101258258) |
| Additional Taxonomies | 208800000X Urology (Licence: OH pending) |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2015-06-30 |