| NPI | 1700939402 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: UT 9393275-1205) | 
| Additional Taxonomies | 208600000X Surgery (Licence: MD Unlisc Med Pract) | 
| 208800000X Urology (Licence: MD Unlisc Med Practit) | |
| 208800000X Urology (Licence: UT 9393275-1205) | |
| 208800000X Urology (Licence: IL 036173396) | |
| 2088P0231X Urology, Pediatric Urology (Licence: IL 036173396) | |
| Enumeration Date | 2007-01-18 | 
| Last Update Date | 2025-07-22 |