| NPI | 1083875819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101250409) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 39020000X) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2022-12-05 |