| NPI | 1164846986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: IN 01099585A) |
| Additional Taxonomies | 208800000X Urology (Licence: FL ME122730) |
| 208800000X Urology (Licence: NY 60 255424) | |
| 208800000X Urology (Licence: GA 74307) | |
| Enumeration Date | 2014-02-13 |
| Last Update Date | 2026-05-08 |