| NPI | 1295881803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA 138171) |
| Additional Taxonomies | 208800000X Urology (Licence: CO 44919) |
| 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: CA 138171) | |
| 2088P0231X (Licence: CA 138171) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2015-11-10 |