| NPI | 1891864203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: AZ 011479) |
| Additional Taxonomies | 208800000X Urology (Licence: TN 5943) |
| 208800000X Urology (Licence: HI DOS 1625) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2025-02-11 |