| NPI | 1972595593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA04624000) |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: NJ 25MA0462400) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2024-04-26 |