| NPI | 1437410339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA10511900) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MT202130) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2019-09-17 |