| NPI | 1841819257 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program | 
| Additional Taxonomies | 2085R0001X (Licence: IN 01095825A) | 
| Enumeration Date | 2020-04-15 | 
| Last Update Date | 2025-10-16 |