| NPI | 1861138331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01094785A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11022173A) |
| Enumeration Date | 2022-05-09 |
| Last Update Date | 2025-07-14 |