| NPI | 1871689968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 163344) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ ma076573) |
| 208800000X Urology (Licence: SC 93580) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2025-02-05 |