| NPI | 1083693394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA03839700) |
| Additional Taxonomies | 208800000X Urology (Licence: MN 74529) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2024-08-23 |