| NPI | 1598919045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: CT 054227) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 25MA08498200) |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2016-03-14 |