| NPI | 1750394771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25ma09096200) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 254322-1) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2022-03-07 |