| NPI | 1386700789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MD MD432669) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MT181482) |
| 208800000X Urology (Licence: DE pending) | |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2025-06-25 |