| NPI | 1932338514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: NY 246701-1) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NY 246701-1) |
| Enumeration Date | 2009-07-05 |
| Last Update Date | 2016-05-12 |