| NPI | 1033180724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA04771800) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD064953L) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2021-06-23 |