| NPI | 1811288152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IN 01073110A) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: IN 01073110A) |
| 208000000X Pediatrics (Licence: OH 35.123870) | |
| 2080S0010X Pediatrics, Sports Medicine (Licence: IN 01073110A) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2022-04-14 |