| NPI | 1528412533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NM MD2020-1074) |
| Additional Taxonomies | 208800000X Urology (Licence: WI 6177-851) |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2022-04-07 |