| NPI | 1700088929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology Pediatric Urology (Licence: GA 83696) |
| Additional Taxonomies | 2088P0231X Urology Pediatric Urology (Licence: TN 43422) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2019-10-08 |