| NPI | 1053573147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WI 65930-20) |
| Additional Taxonomies | 208800000X Urology (Licence: AK 154907) |
| 208800000X Urology (Licence: IL 036132577) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2025-03-11 |