| NPI | 1457592990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology Pediatric Urology (Licence: MI 4301092867) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301092867) |
| Enumeration Date | 2009-03-12 |
| Last Update Date | 2015-08-06 |