| NPI | 1760533533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: AZ 37764) |
| Additional Taxonomies | 208800000X Urology (Licence: OK 22961) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2011-12-07 |