| NPI | 1538275102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ NJ25MA04055000) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD032465E) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2021-04-26 |