| NPI | 1376519017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ MA50961) |
| Additional Taxonomies | 208800000X Urology (Licence: HI MD-14129) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2025-05-01 |