| NPI | 1952003980 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208800000X Urology (Licence: IL 125.086576)  | 
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 4301513689)  | 
| Enumeration Date | 2023-03-21 | 
| Last Update Date | 2025-07-29 |