| NPI | 1376548750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: SC 91544) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 03609775) |
| 208800000X Urology (Licence: ND 12014) | |
| 208800000X Urology (Licence: IN 01078104A) | |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2025-05-06 |