| NPI | 1851648521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MD D76780) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301109161) |
| 208800000X Urology (Licence: NY 60267077) | |
| Enumeration Date | 2012-08-12 |
| Last Update Date | 2023-07-13 |