| NPI | 1063472017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA12258300) |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: CT 045171) |
| 208800000X Urology (Licence: CT 045171) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2025-11-12 |