| NPI | 1558542738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology Pediatric Urology (Licence: SD 8614) |
| Additional Taxonomies | 2088P0231X Urology Pediatric Urology (Licence: LA 201779) |
| 208800000X Urology (Licence: SD 8614) | |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2013-07-01 |