| NPI | 1639243900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD008797E) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 252428-1) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2012-10-03 |