| NPI | 1548266414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA06403300) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ MA064033) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2022-03-10 |