| NPI | 1992741946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD052620L) |
| Additional Taxonomies | 208800000X Urology (Licence: NJ 25MA06313100) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2014-04-29 |