| NPI | 1003880626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME103036) |
| Additional Taxonomies | 208800000X Urology (Licence: CA G88428) |
| 208800000X Urology (Licence: NY 175031) | |
| 208800000X Urology (Licence: IL 036088435) | |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2020-04-27 |