| NPI | 1801327937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: HI md-20438) |
| Additional Taxonomies | 208D00000X General Practice (Licence: HI MD-20438) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2023-08-28 |