| NPI | 1841206711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: ME MD21334) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0101259585) |
| 208800000X Urology (Licence: NY 160847) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2017-09-14 |