| NPI | 1407237019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: IN 01090764A) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01090764A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11018342A) | |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2023-07-28 |