| NPI | 1912142787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: AR E-13439) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 2021044732) |
| 208800000X Urology (Licence: MS 25246) | |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2024-03-07 |