| NPI | 1659328540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: IA MD-46514) |
| Additional Taxonomies | 208800000X Urology (Licence: FL ME121181) |
| 208800000X Urology (Licence: OH 093641) | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2019-09-06 |