| NPI | 1609967132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MI 4301047893) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301047893) |
| 2088P0231X Urology Pediatric Urology (Licence: MI 4301047893) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2012-04-24 |