| NPI | 1396084794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MA 1020930) |
| Additional Taxonomies | 208800000X Urology (Licence: IL 125.066954) |
| 208800000X Urology (Licence: NY 323596) | |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2026-06-16 |