| NPI | 1639156995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WI 47285) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 036072689) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2021-11-24 |