| NPI | 1902399470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A201947) |
| Additional Taxonomies | 208800000X Urology (Licence: IA MD-50949) |
| 208800000X Urology (Licence: MI 4351038068) | |
| Enumeration Date | 2018-06-10 |
| Last Update Date | 2025-12-01 |