| NPI | 1710974365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD463418) |
| Additional Taxonomies | 208800000X Urology (Licence: OH OH35048305L) |
| 208800000X Urology (Licence: OH 35048305) | |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2025-07-07 |