| NPI | 1689730061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: GA 65462) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD432523) |
| 208800000X Urology (Licence: LA 300441) | |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2019-09-09 |