| NPI | 1346818077 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: IN 01095819A) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA MD-53231) | 
| 208000000X Pediatrics (Licence: IA R-12076) | |
| Enumeration Date | 2021-06-17 | 
| Last Update Date | 2025-07-08 |