| NPI | 1942511761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2010024526) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 277804) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2016-07-06 |