| NPI | 1366885451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: DE C1-0013711) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A160936) |
| 208800000X Urology (Licence: PA MD455613) | |
| 208800000X Urology (Licence: NJ 25MA12170700) | |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2024-04-25 |