| NPI | 1245239466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA06069900) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ MA60699) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2022-03-09 |