| NPI | 1700067998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: HI MD-14510) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: HI MD-14510) |
| 207Q00000X Family Medicine (Licence: HI MD-14510) | |
| 208D00000X General Practice (Licence: HI MD-14510) | |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2023-09-22 |