| NPI | 1336382027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD444134) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 25MA09973500) |
| 208800000X Urology (Licence: NC 2015-00289) | |
| Enumeration Date | 2009-04-11 |
| Last Update Date | 2024-05-29 |