| Street | Siewierska 32 | ||
| City/Town | Dabrowa Gornicza | ||
| State/Province/Region | Dabrowa Gornicza | ||
| Zip/Postal Code | 41-260 | ||
| Phone Number | 513 009 519 | ||
| Country | Poland |
| Full Name | doc. Cyprian Urbański | ||
| Gender | male | ||
| Birthday | 1976-10-04 | ||
| Social Security Number | 07240927708 |
| Credit card brand | Diners Club | ||
| Credit card number | 3008942847014908 | ||
| Expire | 2027/1 | ||
| CVV | 877 |