| NPI | 1245293299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: MI 4301089596) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 35.086325) |
| 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: MI 4301089596) | |
| 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: OH 35.086325) | |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2026-09-21 |