| NPI | 1467999474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA12260300) |
| Additional Taxonomies | 208800000X Urology (Licence: MN 28964) |
| 208800000X Urology (Licence: MN 64110) | |
| Enumeration Date | 2017-01-28 |
| Last Update Date | 2024-08-18 |