| NPI | 1942216163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MA MA44892) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA MA44892) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2011-01-21 |