| NPI | 1962630590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology Pediatric Urology (Licence: TX N6984) |
| Additional Taxonomies | 208800000X Urology (Licence: TX N6984) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2024-02-05 |