| NPI | 1023499415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35.142070) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125067321) |
| 208800000X Urology (Licence: MA 282257) | |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2022-01-25 |