| NPI | 1386691772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NM MD2008-0667) |
| Additional Taxonomies | 208800000X Urology (Licence: NM MD2008-0667) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2016-05-19 |