| NPI | 1265620132 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: OH 35123696)  | 
| Additional Taxonomies | 208800000X Urology (Licence: OH 35123696)  | 
| Enumeration Date | 2007-10-04 | 
| Last Update Date | 2024-11-19 |