| NPI | 1447309992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: DC MD048691) |
| Additional Taxonomies | 208800000X Urology (Licence: OK 23542) |
| 2088P0231X (Licence: KY 43980) | |
| 208800000X Urology (Licence: VA 0101243692) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2021-02-10 |