| NPI | 1760557904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: IL 036066056) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35055629) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2011-07-27 |