| NPI | 1558597385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME125410) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MT195269) |
| 208800000X Urology (Licence: IL 036-139198) | |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2022-07-21 |