| NPI | 1508853458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA07851100) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MA07851100) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2022-03-07 |