| NPI | 1568825602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: DC MD210002622) |
| Additional Taxonomies | 208800000X Urology (Licence: WI 81919) |
| 208800000X Urology (Licence: MD D-0091299) | |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2023-09-13 |