| NPI | 1922041938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X (Licence: FL ME141135) |
| Additional Taxonomies | 208800000X Urology (Licence: MN 40599) |
| 208800000X Urology (Licence: CA G76342) | |
| 208800000X Urology (Licence: IL 036120805) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2019-12-26 |