| NPI | 1871810317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2011-00631) |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: DC 165053) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2012-11-26 |