| NPI | 1144621657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA11579000) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 278782) |
| 208800000X Urology (Licence: PA MD465241) | |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2022-08-12 |