| NPI | 1679919294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IN 01078607A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11017036A) |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2021-04-12 |