| NPI | 1821280769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2011034655) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01064387A) |
| 208000000X Pediatrics (Licence: IN 01064387) | |
| 208000000X Pediatrics (Licence: MO 2011034655) | |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2022-10-05 |