| NPI | 1952519308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CO DR.0054556) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 57.009404) |
| 208800000X Urology (Licence: TN MD0000046244) | |
| 208800000X Urology (Licence: VA 0101251164) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2015-01-20 |