| NPI | 1376671396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CT 055043) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 60 241182) |
| 208800000X Urology (Licence: NJ 25MA08557100) | |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2023-06-12 |