| NPI | 1518352871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IN 01080521A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 149756) |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2021-03-31 |