| NPI | 1407370679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: IA MD-53119) |
| Additional Taxonomies | 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: IA MD-53119) |
| 2088P0231X (Licence: IA MD-53119) | |
| 208800000X Urology (Licence: PA MT219097) | |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2024-08-15 |