| NPI | 1942720586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: UT 13489751-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125070062) |
| Enumeration Date | 2017-06-25 |
| Last Update Date | 2023-10-23 |