| NPI | 1831173582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 1135Z9) |
| Additional Taxonomies | 208800000X Urology (Licence: CO CDRH.0055297) |
| 208800000X Urology (Licence: AZ 58636) | |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2022-12-09 |