| NPI | 1093744567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology Pediatric Urology (Licence: CT 42412) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 161053) |
| 2088P0231X Urology Pediatric Urology (Licence: NY 161053) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2016-08-20 |