| NPI | 1326243403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2011025969) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01063484A) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2022-09-12 |