| NPI | 1255546982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OR MD166816) |
| Additional Taxonomies | 208800000X Urology (Licence: NM MD2013-0220) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2019-12-13 |