| NPI | 1144289026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD475105) |
| Additional Taxonomies | 208800000X Urology (Licence: TX R3952) |
| 208800000X Urology (Licence: MD D69612) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2023-03-07 |