| NPI | 1891718060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: AR E-7255) |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: WA MD60034454) |
| 208800000X Urology (Licence: NM 20040585) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2011-12-09 |