| NPI | 1851836134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA OS026187) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NJ 28RI03711400) |
| 208800000X Urology (Licence: PA OT022383) | |
| 208800000X Urology (Licence: NJ 25MB13210400) | |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2026-07-07 |