| NPI | 1568426047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: FL ME111647) |
| Additional Taxonomies | 208800000X Urology (Licence: IL 036-043934) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2019-06-18 |