| NPI | 1932278660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: DC MD 32504) |
| Additional Taxonomies | 208800000X Urology (Licence: MD D32781) |
| 208800000X Urology (Licence: VA 0101229008) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2015-09-25 |