| NPI | 1659692630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MN 54183) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 54183) |
| 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: MN 54183) | |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2020-08-18 |