| NPI | 1972587483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NC 38823) |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: NC 38823) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2022-07-21 |