| NPI | 1760473144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IN 01080135A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 28566) |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2025-10-07 |