| NPI | 1972527158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088F0040X Urology, Female Pelvic Medicine and Reconstructive Surgery (Licence: CT 050730) |
| Additional Taxonomies | 208800000X Urology (Licence: VT 042-0010577) |
| 208800000X Urology (Licence: CT 050730) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2015-02-04 |