| NPI | 1386937696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 294186) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2017011906) |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2020-09-15 |