| NPI | 1487048484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology Pediatric Urology (Licence: PA MD477150) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD477150) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2023-09-01 |