| NPI | 1639128168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME0062982) |
| Additional Taxonomies | 208800000X Urology (Licence: IL 036175972) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2025-07-15 |