| NPI | 1811089691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: OH 35.090366) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 35.090366) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2018-01-18 |