| NPI | 1356406599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WY 6215A) |
| Additional Taxonomies | 2088P0231X Urology Pediatric Urology (Licence: WY 6215A) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2008-06-18 |