| NPI | 1093177891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA11523300) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2021010439) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2022-10-26 |