| NPI | 1205290277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: GA 110433) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 310998) |
| 208800000X Urology (Licence: IA MD-55986) | |
| 208800000X Urology (Licence: OH 35.150572) | |
| 208800000X Urology (Licence: MN 81928) | |
| 208800000X Urology (Licence: TX V0179) | |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2026-07-23 |