| NPI | 1255418885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD068011L) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD068011L) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2024-01-12 |