| NPI | 1437412582 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208800000X Urology (Licence: MO 2017014167)  | 
| Additional Taxonomies | 208800000X Urology (Licence: IL 036156280)  | 
| Enumeration Date | 2012-06-22 | 
| Last Update Date | 2021-12-01 |