| NPI | 1740644145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: DC MD210002642) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MT210872) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2022-09-02 |