| NPI | 1861752347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088F0040X Urology, Female Pelvic Medicine and Reconstructive Surgery (Licence: NY 302443) |
| Additional Taxonomies | 208800000X Urology (Licence: WA MD60829527) |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2024-06-17 |