| NPI | 1225323918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD472144) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD472144) |
| 208600000X Surgery (Licence: MD D89788) | |
| 208800000X Urology (Licence: MD D89788) | |
| 208800000X Urology (Licence: MA L-247622) | |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2021-10-20 |