| NPI | 1205987500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2008-00910) |
| Additional Taxonomies | 208800000X Urology (Licence: MD D0064034) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2021-04-01 |