| NPI | 1821257924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MD D0068713) |
| Additional Taxonomies | 208800000X Urology (Licence: WV 24214) |
| 208800000X Urology (Licence: VA 0101255682) | |
| 208800000X Urology (Licence: DC MD042222) | |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2021-06-22 |