| NPI | 1538134713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 201992-1) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD423775) |
| 208800000X Urology (Licence: OH 35047933) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2011-12-06 |