| NPI | 1366455719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: MD D0036839) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD475754) |
| 208800000X Urology (Licence: VA 0101042376) | |
| 208800000X Urology (Licence: DC 17105) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2024-04-17 |