| NPI | 1285947671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MB11889300) |
| Additional Taxonomies | 208800000X Urology (Licence: FL OS13226) |
| 208800000X Urology (Licence: PA OS016205) | |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2026-04-04 |