| NPI | 1083078166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: DC MD210002347) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A172671) |
| 208800000X Urology (Licence: MD D0095331) | |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2025-01-07 |