| NPI | 1063738631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NM MD2013-0296) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 1063738631) |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2023-08-11 |