| NPI | 1477630440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 219580) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 25MA07256600) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2025-02-06 |