| NPI | 1285795120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MD D0040392) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0040392) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2010-10-14 |