| NPI | 1326145590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA03619000) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 25MA0361000) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2022-03-09 |