| NPI | 1649582735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OR MD187292) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 127889) |
| 208800000X Urology (Licence: NE 6194) | |
| 208800000X Urology (Licence: OR 187292) | |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2019-07-11 |