| NPI | 1669663605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2013013914) |
| Additional Taxonomies | 208800000X Urology (Licence: IL 036133097) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2021-12-01 |