| NPI | 1578728507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: ND 16732) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0102204338) |
| 208800000X Urology (Licence: WV 2483) | |
| 208800000X Urology (Licence: VT 032.0107285) | |
| 208800000X Urology (Licence: NY 281091) | |
| 208800000X Urology (Licence: IN 02006181A) | |
| 208800000X Urology (Licence: MI EMC0009556) | |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2026-08-03 |