| NPI | 1508093121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 260761) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD450595) |
| 2086X0206X Surgery, Surgical Oncology (Licence: VA 0101237809) | |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2014-01-29 |