| NPI | 1164712469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: DC MD044177) |
| Additional Taxonomies | 208800000X Urology (Licence: MD D0081738) |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2021-08-24 |