| NPI | 1225667116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: IN 02008924A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 5101027453) |
| 208000000X Pediatrics (Licence: MI 5151014402) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MI 5151014402) | |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2026-05-27 |