| NPI | 1730227125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X (Licence: NY 247542) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD429306) |
| 208800000X Urology (Licence: NY 247542-1) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2023-12-18 |