| NPI | 1881705523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: IA MD-46379) |
| Additional Taxonomies | 208800000X Urology (Licence: ID M-12670) |
| 208800000X Urology (Licence: WA MD60515618) | |
| 208800000X Urology (Licence: TX J5291) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-08-12 |