| NPI | 1912067273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: FL ME131967) |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: AL 18271) |
| 2088P0231X Urology, Pediatric Urology (Licence: CA G188367) | |
| 208800000X Urology (Licence: AL 18271) | |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2026-07-17 |