| NPI | 1609020130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 302748) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10032207) |
| 208800000X Urology (Licence: TX BP10032207) | |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2021-11-11 |