| NPI | 1689623845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: MO 2001013756) |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: KS 04-29198) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2025-11-25 |