| NPI | 1265775308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WV 25998) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 2016-01662) |
| 208800000X Urology (Licence: NY 158261) | |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2023-10-10 |