| NPI | 1578539870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X (Licence: RI MD16872) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD068048L) |
| 208800000X Urology (Licence: CA G79697) | |
| 2088P0231X (Licence: CA G79697) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2020-01-30 |