| NPI | 1366092959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 01086385A) |
| Enumeration Date | 2019-09-16 |
| Last Update Date | 2025-03-27 |