| NPI | 1285164038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11022146A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 271303) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2022-07-06 |