| NPI | 1043219546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NE 18671) |
| Additional Taxonomies | 174400000X Specialist (Licence: IA 29568) |
| 174400000X Specialist (Licence: NE 18671) | |
| 208800000X Urology (Licence: IA MD-29568) | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2024-04-09 |