| NPI | 1851368468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 162928) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 25MA06073700) |
| 208800000X Urology (Licence: PA MD479749) | |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2024-08-19 |