| NPI | 1568521706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: DC MD10220) |
| Additional Taxonomies | 208800000X Urology (Licence: MD D0018842) |
| 208800000X Urology (Licence: VA 0101034294) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2020-05-19 |