| NPI | 1811301955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: KS 04-46285) |
| Additional Taxonomies | 208800000X Urology (Licence: IL 036.142681) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2022-09-19 |