| NPI | 1821272006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA09055000) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A95265) |
| 208800000X Urology (Licence: TX N6549) | |
| Enumeration Date | 2007-12-23 |
| Last Update Date | 2013-01-18 |