| NPI | 1689808875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 274532) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125054165) |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2020-01-09 |