| NPI | 1992865257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: GA 036519) |
| Additional Taxonomies | 208800000X Urology (Licence: IA MD46749) |
| 208800000X Urology (Licence: KY 53160) | |
| 208800000X Urology (Licence: PA MD468571) | |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2020-12-03 |