| NPI | 1629424585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: TN 64329) |
| Additional Taxonomies | 208800000X Urology (Licence: UT 12275776-1205) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2024-05-14 |