| NPI | 1831488329 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208800000X Urology (Licence: IN 01082251A) | 
| Additional Taxonomies | 208800000X Urology (Licence: NJ 25MA10042200) | 
| Enumeration Date | 2011-04-05 | 
| Last Update Date | 2025-03-03 |