| NPI | 1023300886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: IA MD43518) |
| Additional Taxonomies | 208800000X Urology (Licence: FL TRN15970) |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2026-05-06 |