| NPI | 1821448408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: IL 036160146) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 267836) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2022-06-15 |