| NPI | 1699927566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA08557300) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 60 238670) |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2024-05-16 |