| NPI | 1992859805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: AZ 74839) |
| Additional Taxonomies | 208800000X Urology (Licence: ID M-15122) |
| 208800000X Urology (Licence: PA MD465614) | |
| 208800000X Urology (Licence: FL ME100410) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2024-10-03 |