| NPI | 1801090691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: CO DR.0051893) |
| Additional Taxonomies | 208800000X Urology (Licence: TX N4361) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2018-11-30 |