| NPI | 1003298019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA10839500) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A137177) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2025-09-03 |