| NPI | 1396935912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A117518) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 256182) |
| 208800000X Urology (Licence: PA MD445817) | |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2013-08-14 |