| NPI | 1700056140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA a88654) |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: CA A88654) |
| 2088P0231X Urology, Pediatric Urology (Licence: MA 239867) | |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2022-06-29 |