| NPI | 1619956042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WI 56818) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01061489A) |
| 208000000X Pediatrics (Licence: WI 56818) | |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2017-04-28 |