| NPI | 1184989915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2024041565) |
| Additional Taxonomies | 208800000X Urology (Licence: IL 036136798) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2025-06-03 |