| NPI | 1972686418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: OR MD12622) |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: WA MD00024368) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2007-07-08 |