| NPI | 1487318473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: NY P110449) |
| Additional Taxonomies | 208800000X Urology (Licence: NY P110449) |
| Enumeration Date | 2021-10-26 |
| Last Update Date | 2021-10-31 |