| NPI | 1003441825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: HI MD-22353) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208600000X Surgery (Licence: GA 109991) | |
| Enumeration Date | 2020-03-12 |
| Last Update Date | 2026-04-29 |