| NPI | 1609047307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: RI MD17355) |
| Additional Taxonomies | 208800000X Urology (Licence: NH 15706) |
| 208800000X Urology (Licence: NY 238534) | |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2021-01-12 |