| NPI | 1720406937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: NJ 25MA12115700) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 25MA12115700) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2024-04-24 |