| NPI | 1558352161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD453477) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 39448) |
| 208800000X Urology (Licence: OH 35-72117) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2024-10-24 |