| NPI | 1245436518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME131655) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME131655) |
| 208800000X Urology (Licence: NY 242246) | |
| 208800000X Urology (Licence: NJ 25MA08484700) | |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2022-07-17 |