| NPI | 1437145455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 20885) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01030087A) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2021-11-22 |