NPI | 1073135935 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
Additional Taxonomies | 208600000X Surgery (Licence: NJ MD-GTL-20-00148) |
208800000X Urology (Licence: NJ MD-GTL-20-00148) | |
Enumeration Date | 2020-05-14 |
Last Update Date | 2025-04-28 |