| NPI | 1598884496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME112955) |
| Additional Taxonomies | 2088F0040X Urology, Female Pelvic Medicine and Reconstructive Surgery (Licence: FL ME112955) |
| 2088P0231X (Licence: FL ME112955) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2012-06-21 |