| NPI | 1659661338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA10319400) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD458335) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2018-08-30 |