| NPI | 1245674480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: CA A131901) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A131901) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2022-08-12 |