| NPI | 1154386324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: OH 35072454) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 35072454G) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2026-08-21 |