| NPI | 1871597443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: LA MD04720R) |
| Additional Taxonomies | 208800000X Urology (Licence: LA MD.04720R) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2008-10-03 |