| NPI | 1336174085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: FL ME180658) |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: GA 055002) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2026-06-10 |