| NPI | 1063857571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX R6009) |
| Additional Taxonomies | 2088P0231X Urology Pediatric Urology (Licence: TX R6009) |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2023-01-24 |