| NPI | 1104288356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: CA A176647) |
| Additional Taxonomies | 208800000X Urology (Licence: IL 036148006) |
| Enumeration Date | 2016-03-27 |
| Last Update Date | 2022-07-11 |