| NPI | 1942451992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A111452) |
| Additional Taxonomies | 208800000X Urology (Licence: MD D70357) |
| 208800000X Urology (Licence: VA 0101247479) | |
| 208800000X Urology (Licence: DC MD036805) | |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2023-07-17 |