| NPI | 1093802134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME117564) |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: SD 7748) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2019-10-08 |