| NPI | 1194986026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OR MD185934) |
| Additional Taxonomies | 208800000X Urology (Licence: ND 14047) |
| 208800000X Urology (Licence: KS 0438559) | |
| 208800000X Urology (Licence: VA 0101247217) | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2019-07-23 |