| NPI | 1619298502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: FL ME131180) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301096766) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2024-06-27 |