| NPI | 1194081067 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IN 02005311A) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 5101019826) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-05 | 
| Last Update Date | 2023-08-30 |