| NPI | 1255373346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 239868) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 25MA07789500) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2013-01-03 |