| NPI | 1295046605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: HI DOS-1450) |
| Additional Taxonomies | 208D00000X General Practice (Licence: HI DOS-1450) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2022-10-05 |