| NPI | 1295883312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA05925800) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 59258) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2023-03-07 |