| NPI | 1578944971 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01080265A)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11018377A)  | 
| Enumeration Date | 2015-06-11 | 
| Last Update Date | 2022-06-02 |