| NPI | 1962662312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA08139900) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 008199) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2022-03-10 |