| NPI | 1225007875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology Pediatric Urology (Licence: FL ME115598) |
| Additional Taxonomies | 2088P0231X Urology Pediatric Urology (Licence: MI 4301077491) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2013-04-03 |