| NPI | 1427258193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: IN 01063393A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01063393A) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2019-08-20 |