| NPI | 1487710893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TN MD47049) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MT188369) |
| 208800000X Urology (Licence: PA MD439992) | |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2012-07-09 |