| NPI | 1578539870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: RI MD16872) |
| Additional Taxonomies | 208800000X Urology (Licence: MA 288471) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2026-03-10 |