| NPI | 1649418328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: TX Q7833) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10032206) |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2019-09-10 |