| NPI | 1114156692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD460219) |
| Additional Taxonomies | 208800000X Urology (Licence: IL 125-055714) |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2022-04-28 |