| NPI | 1427021732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME131772) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 25MA06214800) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2022-05-02 |