| NPI | 1427369867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MB11695300) |
| Additional Taxonomies | 208800000X Urology (Licence: PA OS015925) |
| 208800000X Urology (Licence: MI 5101022954) | |
| 208800000X Urology (Licence: SC 83392) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2023-12-02 |