| NPI | 1821159187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NM MD2021-0337) |
| Additional Taxonomies | 208800000X Urology (Licence: OR MD24434) |
| 208800000X Urology (Licence: AZ 29019) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2021-07-07 |