| NPI | 1659575405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CT 46705) |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: CT 46705) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2019-01-14 |