| NPI | 1619083961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: CA G83089) |
| Additional Taxonomies | 208800000X Urology (Licence: CA G83089) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2011-11-16 |