| NPI | 1801991476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OR MD26963) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR MD26963) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2017-03-01 |