| NPI | 1164726329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: GA 074034) |
| Additional Taxonomies | 208800000X Urology (Licence: SC TL36566) |
| 2088F0040X Urology, Female Pelvic Medicine and Reconstructive Surgery (Licence: SC TL36566) | |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2023-03-09 |