| NPI | 1568562254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA os012038) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ MB08004900) |
| 208800000X Urology (Licence: NJ MB08004900) | |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2021-05-20 |