| NPI | 1740253483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: CT 035121) |
| Additional Taxonomies | 208800000X Urology (Licence: CT 035121) |
| 2088P0231X Urology, Pediatric Urology (Licence: NY 286455) | |
| 208800000X Urology (Licence: NY 286455) | |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2017-02-28 |