| NPI | 1356380604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology Pediatric Urology (Licence: NY 148828) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 148828) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2011-08-26 |