| NPI | 1376784850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: AZ 62118) |
| Additional Taxonomies | 208800000X Urology (Licence: FL TRN13877) |
| 208800000X Urology (Licence: OH 35128675) | |
| 208800000X Urology (Licence: NY 272442) | |
| Enumeration Date | 2009-03-13 |
| Last Update Date | 2022-10-18 |