| NPI | 1679544365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MD D0091343) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 25MA06345000) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2021-09-08 |