| NPI | 1245461037 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11018398A) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125056073) | 
| Enumeration Date | 2009-07-28 | 
| Last Update Date | 2015-06-18 |