| NPI | 1811157100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NM MD2010-0319) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 25MA08386700) |
| 174400000X Specialist (Licence: NM MD2010-0319) | |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2022-07-21 |