| NPI | 1841379187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IN 01073977A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 28666) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2023-11-03 |