| NPI | 1710050034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101042792) |
| Additional Taxonomies | 208800000X Urology (Licence: DC MD13322) |
| 208800000X Urology (Licence: MD D0036953) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2012-12-06 |