| NPI | 1821296005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: KY 47881) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208800000X Urology (Licence: TN 49404) | |
| 208800000X Urology (Licence: IN 01075052A) | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2015-04-09 |