| NPI | 1750646691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X (Licence: IN 01072466A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11016534A) |
| Enumeration Date | 2012-07-06 |
| Last Update Date | 2020-11-19 |