| NPI | 1306425376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11024015A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 72033) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2025-06-18 |