| NPI | 1154386324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35072454G) |
| Additional Taxonomies | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: OH 35072454) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2014-05-29 |