| NPI | 1235663147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: KY 58926) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208800000X Urology (Licence: IN 01092561A) | |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2025-02-10 |