| NPI | 1528050895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME140736) |
| Additional Taxonomies | 208800000X Urology (Licence: DC MD10133) |
| 208800000X Urology (Licence: MD D0020393) | |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2021-02-23 |