| NPI | 1780704734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: AZ 57907) |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: NE 26995) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2019-08-23 |