| NPI | 1134190820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD479949) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 25MA05931400) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2023-02-01 |