| NPI | 1003078932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MA 1014839) |
| Additional Taxonomies | 208800000X Urology (Licence: VT 042.0012522) |
| 208800000X Urology (Licence: NY 256472-1) | |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2023-05-31 |