| NPI | 1336118850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 320798-01) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 25ma06646700) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2025-04-01 |