| NPI | 1548367006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA06560100) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: NJ MA65601) |
| Enumeration Date | 2006-09-19 |
| Last Update Date | 2022-03-07 |