| NPI | 1275544454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology Pediatric Urology (Licence: UT 171674-1205) |
| Additional Taxonomies | 2086S0120X Surgery Pediatric Surgery (Licence: UT 841716741205) |
| 208800000X Urology (Licence: UT 841716741205) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2017-11-28 |