| NPI | 1235584533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: ID M-15799) |
| Additional Taxonomies | 208800000X Urology (Licence: TN 1235584533) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2022-05-20 |