| NPI | 1548526239 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: IN 11016452A) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2012-04-06 | 
| Last Update Date | 2015-08-18 |