| NPI | 1871588277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: GA 39916) |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: TN 31240) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2019-10-30 |