| NPI | 1609130558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IN 02005070A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 5522) |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2022-06-21 |