| NPI | 1770879504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CO DR.0058301) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125060207) |
| 208800000X Urology (Licence: CA 140429) | |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2022-07-21 |