| NPI | 1942788385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11023132A) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 21485) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-07-28 |
| Last Update Date | 2023-06-20 |