| NPI | 1700939402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: UT 9393275-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD Unlisc Med Pract) |
| 208800000X Urology (Licence: MD Unlisc Med Practit) | |
| 208800000X Urology (Licence: UT 9393275-1205) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2021-11-23 |