| NPI | 1053491415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IN 01068714A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 40208) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2015-07-24 |