| NPI | 1588185482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A176478) |
| Additional Taxonomies | 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: CA A176478) |
| 2088P0231X Urology, Pediatric Urology (Licence: CA A176478) | |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2026-09-08 |