| NPI | 1871713859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: NC 2006-01364) |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: SC 29564) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2013-07-29 |