NPI | 1639169774 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: NV NV10623) |
Additional Taxonomies | 174400000X Specialist (Licence: NV 10623) |
Enumeration Date | 2005-10-27 |
Last Update Date | 2018-03-17 |