| NPI | 1871682260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 142353) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 142353-1) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2022-08-15 |