| NPI | 1467406140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: ND 20273) |
| Additional Taxonomies | 208800000X Urology (Licence: FL ME113973) |
| 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: FL ME113973) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2025-09-24 |