| NPI | 1033195391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA06682400) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 25MA06682466824) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2022-03-07 |