| NPI | 1891174017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WI 76834-020) |
| Additional Taxonomies | 208800000X Urology (Licence: IA MD-48337) |
| 2088F0040X Urology, Female Pelvic Medicine and Reconstructive Surgery (Licence: IA MD-48337) | |
| 2088F0040X Urology, Female Pelvic Medicine and Reconstructive Surgery (Licence: WI 76834-020) | |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2023-01-25 |