| NPI | 1467815530 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208800000X Urology (Licence: IN 01085346A) | 
| Additional Taxonomies | 208800000X Urology (Licence: ID M-16995) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-05 | 
| Last Update Date | 2023-03-01 |