| NPI | 1730155391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: DC MD14574) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: DC MD14574) |
| 208800000X Urology (Licence: PA MD467181) | |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2021-11-10 |