| NPI | 1154314193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MI 4301067565) |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: MI SJ067565) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2023-09-20 |