| NPI | 1427069954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology Pediatric Urology (Licence: FL ME68695) |
| Additional Taxonomies | 208800000X Urology (Licence: FL ME68695) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2011-09-15 |