| NPI | 1801424890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: TN 76800) |
| Additional Taxonomies | 208800000X Urology (Licence: WA ML.61060147) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2026-05-15 |