| NPI | 1366900508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: IL 036.169235) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 32192301) |
| 208800000X Urology (Licence: WI 84818-20) | |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2025-01-07 |