| NPI | 1083711121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NM MD2008-0654) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD071992L) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2011-08-11 |