| NPI | 1447306345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA08183400) |
| Additional Taxonomies | 2088P0231X (Licence: NJ 25MA08183400) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2022-03-09 |