| NPI | 1174844245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WI 909-320) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 128256) |
| 208800000X Urology (Licence: CO DR.0058228) | |
| 208800000X Urology (Licence: IA MD-45876) | |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2021-12-07 |