| NPI | 1891750196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: DC md038156) |
| Additional Taxonomies | 208800000X Urology (Licence: WI 49267) |
| 208800000X Urology (Licence: PA MD431151) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2012-02-24 |