| NPI | 1730601105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MDR-8320) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL51209) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2024-02-25 |