| NPI | 1003884578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: ME MD19913) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NH 14482) |
| 208600000X Surgery (Licence: MA 224790) | |
| 208800000X Urology (Licence: NH 14482) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2022-05-02 |