| NPI | 1639344534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA MD60019018) |
| Additional Taxonomies | 208800000X Urology (Licence: IL 125-044725) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2013-06-25 |