NPI | 1902255888 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208800000X Urology (Licence: NJ 25MB10982600) |
Additional Taxonomies | 208800000X Urology (Licence: OH 34.015010) |
Enumeration Date | 2016-06-10 |
Last Update Date | 2023-08-28 |