| NPI | 1780643098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: IN 01047208A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: HI MD-18880) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2021-10-07 |