| NPI | 1649650631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: CA 20A23861) |
| Additional Taxonomies | 208800000X Urology (Licence: CA 20A23861) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2025-10-10 |