| NPI | 1235442534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A142296) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 25MA08786700) |
| 208800000X Urology (Licence: MD D0076585) | |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2025-10-23 |