| NPI | 1205497336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11023909A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 6043032) |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2024-07-28 |