| NPI | 1710280904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MD D96316) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 003517) |
| 208800000X Urology (Licence: NY 269817) | |
| Enumeration Date | 2010-12-10 |
| Last Update Date | 2023-07-06 |