| NPI | 1760974299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA12284100) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A185689) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2024-06-17 |