| NPI | 1164669404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: FL OS10946) |
| Additional Taxonomies | 208800000X Urology (Licence: IL 125047406) |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2019-04-02 |