| NPI | 1871932608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 02005334A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11017307A) |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2020-12-22 |