| NPI | 1295996122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA MD61022696) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2008017175) |
| 208800000X Urology (Licence: IL 036137930) | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2020-05-22 |