NPI | 1710618897 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02007414A) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11022204A) |
Enumeration Date | 2022-06-21 |
Last Update Date | 2023-12-28 |