| NPI | 1417915406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: CA G55169) |
| Additional Taxonomies | 208800000X Urology (Licence: CA G55169) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2022-05-05 |