| NPI | 1538666540 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: AR E-19540) | 
| Additional Taxonomies | 208600000X Surgery (Licence: AR E-19540) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-07 | 
| Last Update Date | 2025-08-19 |