| NPI | 1902025596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: GA 074749) |
| Additional Taxonomies | 208800000X Urology (Licence: IL 125053804) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2023-07-25 |