| NPI | 1154383743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: GA 080664) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 25MB07559100) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2023-09-20 |