| NPI | 1063863298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NC 2019-02229) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 7758) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: IN 01094696A) | |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2024-09-26 |