| NPI | 1770754137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TN MD0000047250) |
| Additional Taxonomies | 208800000X Urology (Licence: FL ME99488) |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2023-04-05 |