| NPI | 1407018575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA09245100) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD445879) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2023-07-20 |