| NPI | 1629020292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX M3237) |
| Additional Taxonomies | 207VF0040X Obstetrics & Gynecology Female Pelvic Medicine and Reconstructive Surgery (Licence: TX M3237) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2019-03-18 |