| NPI | 1306173661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 325683) |
| Additional Taxonomies | 208800000X Urology (Licence: AR E-6311) |
| 208800000X Urology (Licence: MI 4301502559) | |
| Enumeration Date | 2009-11-06 |
| Last Update Date | 2023-10-09 |