| NPI | 1255626743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: IN 01072723A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01072723A) |
| 208D00000X General Practice (Licence: IN 01072723A) | |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2025-01-07 |