| NPI | 1861657108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: NY 256141) |
| Additional Taxonomies | 2088F0040X Urology, Female Pelvic Medicine and Reconstructive Surgery (Licence: NY 256141) |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2023-06-11 |