| NPI | 1497845671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MA 249992) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 2005-00198) |
| 208800000X Urology (Licence: RI MD12326) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2013-09-12 |