| NPI | 1124778550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11022760A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R3803) |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2023-10-29 |