| NPI | 1134410541 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: IN 01078042A) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.124064) | 
| Enumeration Date | 2011-04-20 | 
| Last Update Date | 2023-09-28 |