| NPI | 1982888228 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208800000X Urology (Licence: NE 36801)  | 
| Additional Taxonomies | 208800000X Urology (Licence: IA MD-54647)  | 
| 208800000X Urology (Licence: CA C131145)  | |
| Enumeration Date | 2007-12-21 | 
| Last Update Date | 2025-06-23 |