| NPI | 1679699714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: TX K8388) |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: TX k8388) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2024-04-24 |