| NPI | 1710974753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MN 36114) |
| Additional Taxonomies | 2088F0040X Urology, Female Pelvic Medicine and Reconstructive Surgery (Licence: MN 36114) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2014-09-15 |