| 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 |