| NPI | 1821164013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: MD D52172) |
| Additional Taxonomies | 208800000X Urology (Licence: DC MD30279) |
| 208800000X Urology (Licence: VA 0101055972) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2024-12-09 |