| NPI | 1144338336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 243475) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD423461) |
| 208800000X Urology (Licence: WI 42243) | |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2024-06-10 |