| NPI | 1134419328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: DC MD045666) |
| Additional Taxonomies | 208800000X Urology (Licence: MD D84054) |
| 208800000X Urology (Licence: MO 2016025625) | |
| Enumeration Date | 2011-04-09 |
| Last Update Date | 2022-07-21 |