| NPI | 1740819796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: AZ 64532) |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: WA MD.61665454) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2025-12-09 |