| NPI | 1679776272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: MN 70452) |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: TX Q4322) |
| Enumeration Date | 2007-06-09 |
| Last Update Date | 2021-11-09 |