| NPI | 1598754640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA06972400) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ MA069724) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2022-03-09 |