| NPI | 1750688735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: MD D93287) |
| Additional Taxonomies | 208800000X Urology (Licence: GA 82208) |
| 208800000X Urology (Licence: VA 0101272890) | |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2024-02-20 |