| NPI | 1447226139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ MA06285100) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD056570L) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2016-03-24 |