| NPI | 1104843556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: NC 9500849) |
| Additional Taxonomies | 208800000X Urology (Licence: NC 9500849) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2021-01-04 |