| NPI | 1841288750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 268172) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0101041430) |
| 208800000X Urology (Licence: NC 31767) | |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2023-04-28 |