| NPI | 1275513665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: OK 44654) |
| Additional Taxonomies | 208800000X Urology (Licence: AZ 27183) |
| 2088P0231X Urology, Pediatric Urology (Licence: NC 2013-00195) | |
| 2088P0231X Urology, Pediatric Urology (Licence: TX J1876) | |
| 2088P0231X Urology, Pediatric Urology (Licence: CA C147490) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2025-03-27 |