| NPI | 1639126485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NJ ma047922) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 25MA04792200) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2024-04-10 |