| NPI | 1447562418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 300549) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 390200000X) |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2025-01-13 |