| NPI | 1639168016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 24258) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01079163A) |
| 174400000X Specialist (Licence: TN 24258) | |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2022-09-14 |