| NPI | 1174960744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: IN 01087982A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 264935) |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2022-07-18 |