NPI | 1174584619 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: FL ME138919) |
Additional Taxonomies | 208800000X Urology (Licence: MN 30855) |
Enumeration Date | 2006-03-31 |
Last Update Date | 2019-04-19 |