| NPI | 1407803240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: WI 36790) |
| Additional Taxonomies | 208800000X Urology (Licence: ID M-17776) |
| 2088P0231X Urology, Pediatric Urology (Licence: FL ME170686) | |
| 208800000X Urology (Licence: WI 36790) | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2026-05-12 |