| NPI | 1295750701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA09395500) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 207433) |
| 208800000X Urology (Licence: PA MD426470) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2018-05-18 |