| NPI | 1164515193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: TN MD21670) |
| Additional Taxonomies | 208800000X Urology (Licence: TN MD21670) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2022-03-30 |