| NPI | 1447633516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 01012769972) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 2024-02742) |
| 208800000X Urology (Licence: WV 34307) | |
| 208800000X Urology (Licence: MD D0101534) | |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2024-09-24 |