| NPI | 1912382417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: FL MFC1770) |
| Additional Taxonomies | 208800000X Urology (Licence: FL TRN21285) |
| Enumeration Date | 2015-07-25 |
| Last Update Date | 2017-05-25 |