| NPI | 1801971270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 161819) |
| Additional Taxonomies | 208800000X Urology (Licence: MA 150229) |
| 208800000X Urology (Licence: MD D26397) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2012-10-08 |