NPI | 1124647409 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11022914A) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 4351046143) |
Enumeration Date | 2020-04-15 |
Last Update Date | 2023-07-03 |