| NPI | 1073554275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: MS 06918) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 4774) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2012-07-24 |