| NPI | 1528370558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: HI DOS-2343) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: PA OS016563) |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2023-05-02 |