| NPI | 1003029836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA07897500) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ MA078975) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2022-03-09 |