| NPI | 1255488078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: NE 30332) |
| Additional Taxonomies | 208800000X Urology (Licence: NE 30332) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2018-05-15 |