| NPI | 1841460821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA08789300) |
| Additional Taxonomies | 208800000X Urology (Licence: MA 222489) |
| 208800000X Urology (Licence: PA MD436796) | |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2020-03-10 |