| NPI | 1427092238 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: ND 10772)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01059605A)  | 
| Enumeration Date | 2006-06-15 | 
| Last Update Date | 2022-03-29 |