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 | 2024-03-11 |