| NPI | 1699182139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OK 44126) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01078389A) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2026-03-11 |