| NPI | 1477997690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: NY 282292-01) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 282292-01) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2026-09-01 |