| NPI | 1619085610 |
|---|---|
| Former Name | SHAHABUDDIN MOHAMED |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL me96086) |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2023-01-09 |