| NPI | 1740868876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider (Licence: IN 02008215A) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 02008215A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2025-07-16 |