| NPI | 1235273848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA08369000) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD431651) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2025-09-12 |