| NPI | 1730191743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 196120-1) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 196120-1) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2012-09-25 |