| NPI | 1407082068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IN 01072038A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 46874) |
| 208000000X Pediatrics (Licence: KY 46874) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: IN 01072038A) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: KY 46874) | |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2021-02-15 |