| NPI | 1184654162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA07766300) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 245155) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2024-05-01 |