| NPI | 1134626153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MD D99516) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 25MA11792900) |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2025-03-12 |