| NPI | 1063892610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IN 02005033A) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 02005033A) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2020-05-27 |