| NPI | 1811911761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA05269500) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ MA05269500) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2022-10-14 |