| NPI | 1679557011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35071) |
| Additional Taxonomies | 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: OH 35-071577) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2015-10-28 |