| NPI | 1497042030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MS 23259) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MS T-2406) |
| Enumeration Date | 2011-07-04 |
| Last Update Date | 2023-11-27 |