| NPI | 1982891941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MA08746600) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 249688) |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2024-03-14 |