| NPI | 1407950934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: TN MD0000006683) |
| Additional Taxonomies | 208800000X Urology (Licence: TN MD0000006683) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2007-07-09 |