| NPI | 1891768925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: DC MD21045) |
| Additional Taxonomies | 208800000X Urology (Licence: MD D0052516) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2023-07-13 |