| NPI | 1245225622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: KY 19584) |
| Additional Taxonomies | 2088P0231X Urology Pediatric Urology (Licence: KY 19584) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2022-04-04 |