| NPI | 1053552109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology Pediatric Urology (Licence: DC MD042607) |
| Additional Taxonomies | 2088P0231X Urology Pediatric Urology (Licence: CA A82106) |
| Enumeration Date | 2009-03-19 |
| Last Update Date | 2014-10-21 |