| NPI | 1205810520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2002031745) |
| Additional Taxonomies | 208800000X Urology (Licence: IL 036-108257) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2021-12-01 |