| NPI | 1053970442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 01091492A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125075903) |
| 208600000X Surgery (Licence: SC LL82357) | |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2023-09-11 |