| NPI | 1851892400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116038928) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01084205A) |
| 208D00000X General Practice (Licence: IN 01084205A) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2024-07-24 |