| NPI | 1831629104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: SC 94181) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL51289) |
| 208800000X Urology (Licence: IL 036170502) | |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2025-09-16 |