| NPI | 1720473358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01085305A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MD470087) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2021-09-14 |