| NPI | 1174733513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: TN MD47185) |
| Additional Taxonomies | 208800000X Urology (Licence: AL 27051) |
| 208800000X Urology (Licence: TN 47185) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2022-03-26 |