| NPI | 1891959292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD433552) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 60 269695) |
| 208800000X Urology (Licence: NY FC0732556) | |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2021-03-13 |