| NPI | 1578726477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: KY 47046) |
| Additional Taxonomies | 208600000X Surgery (Licence: MS 709--L) |
| 208800000X Urology (Licence: KY 47046) | |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2021-01-15 |