| NPI | 1699034546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 283711-01) |
| Additional Taxonomies | 208800000X Urology (Licence: VT 042.0017181) |
| 208800000X Urology (Licence: NH 24608) | |
| 208800000X Urology (Licence: CT 75427) | |
| 208800000X Urology (Licence: NJ 25MA11945900) | |
| 208800000X Urology (Licence: IL 036.146058) | |
| 208800000X Urology (Licence: PA MD483661) | |
| 208800000X Urology (Licence: MA 1017045) | |
| 208800000X Urology (Licence: MD D0103168) | |
| 208800000X Urology (Licence: DE C1-0026182) | |
| 208800000X Urology (Licence: ME MD27383) | |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2025-10-23 |