| NPI | 1932127271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 161539) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 161539) |
| 208600000X Surgery (Licence: NY 161539) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2014-05-21 |