| NPI | 1740496686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: AR E-6863) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 34.009054) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2012-04-19 |