| NPI | 1881853877 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208800000X Urology (Licence: TX N5018) | 
| Additional Taxonomies | 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: TX N5018) | 
| Enumeration Date | 2008-06-04 | 
| Last Update Date | 2021-06-07 |