| NPI | 1952325821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA05345000) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ MA05345) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2022-03-10 |