| NPI | 1699260026 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2021025590)  | 
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: IN 01093611A)  | 
| Enumeration Date | 2018-06-27 | 
| Last Update Date | 2024-06-10 |