| NPI | 1407083199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD451720) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2009013400) |
| 208800000X Urology (Licence: NJ 25MA10072800) | |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2024-04-03 |