| NPI | 1295991867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 267793-1) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 267793-1) |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2017-05-03 |