| NPI | 1558384388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: UT 6078212-1205) |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: ID M-13870) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2021-12-16 |