| NPI | 1477721207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: CA A87300) |
| Additional Taxonomies | 208800000X Urology (Licence: IL 036 120136) |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2021-11-17 |