| NPI | 1811212368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: AZ 74355) |
| Additional Taxonomies | 208800000X Urology (Licence: MD D0082296) |
| 208800000X Urology (Licence: NY 298898) | |
| Enumeration Date | 2010-03-27 |
| Last Update Date | 2025-06-10 |