| NPI | 1073931150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OR MD203703) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD467561) |
| 208800000X Urology (Licence: PA MT205652) | |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2021-09-14 |