| NPI | 1740300649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX Q3524) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 227833) |
| 208800000X Urology (Licence: IL 036.12355) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-11-20 |