| NPI | 1861652257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 2011-01856) |
| Additional Taxonomies | 208800000X Urology (Licence: SC 36583) |
| 208800000X Urology (Licence: IL 036-125057) | |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2022-07-08 |