| NPI | 1255388591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MD D19755) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD026356E) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2016-03-22 |