| NPI | 1649732314 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: IN 02006423A)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2019-04-02 | 
| Last Update Date | 2021-12-15 |