| NPI | 1740439496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IN 01049378A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01049378A) |
| 208M00000X Hospitalist (Licence: IN 01049378A) | |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2015-01-30 |