| NPI | 1235123704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: IN 01055407A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01055407A) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2023-05-01 |