| NPI | 1710919006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2014-00249) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 191894-1) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2023-07-21 |