| NPI | 1689628935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA08041600) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MA08041600) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2016-08-17 |