| NPI | 1255637146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA09497400) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 269765) |
| 208800000X Urology (Licence: OH 35.097157) | |
| Enumeration Date | 2011-02-10 |
| Last Update Date | 2022-03-10 |