| NPI | 1508844697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME163079) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 149474-1) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2023-11-09 |