| NPI | 1932317633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA08678100) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD430643) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2022-03-09 |