| NPI | 1649092628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology Pediatric Urology (Licence: OH 80.000081) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 80.000081) |
| Enumeration Date | 2024-10-30 |
| Last Update Date | 2025-01-28 |