| NPI | 1336345214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IN 01065561A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WV 22735) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2023-10-09 |