| NPI | 1326150079 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208800000X Urology (Licence: NH LT4283) | 
| Additional Taxonomies | 208800000X Urology (Licence: PA MD430490) | 
| 208800000X Urology (Licence: IN 01067218A) | |
| 208800000X Urology (Licence: NY 153788) | |
| Enumeration Date | 2006-08-31 | 
| Last Update Date | 2023-10-31 |