| NPI | 1538164207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25IA13049500) |
| Additional Taxonomies | 208800000X Urology (Licence: FL ME64146) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2026-05-13 |