| NPI | 1588193320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MA 1018427) |
| Additional Taxonomies | 208800000X Urology (Licence: SC 55137) |
| 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: MI 4351048863) | |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2024-08-15 |