| NPI | 1215429576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA11839500) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD471698) |
| Enumeration Date | 2018-06-03 |
| Last Update Date | 2023-07-31 |