| NPI | 1144726407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: NY 334181) |
| Additional Taxonomies | 208800000X Urology (Licence: GA 98790) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2025-08-26 |