| NPI | 1568721843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: CA A124694) |
| Additional Taxonomies | 208800000X Urology (Licence: IL 036.143791) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2021-11-29 |