| NPI | 1912098880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: OR MD21464) |
| Additional Taxonomies | 174400000X Specialist (Licence: AK AK6854) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2022-01-17 |