| NPI | 1710918057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: MD D47490) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD445150) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2019-10-11 |