| NPI | 1619288123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: IN 01087149A) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME115043) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2022-06-28 |