| NPI | 1861028870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IN 01094551A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WV 32790) |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2024-08-02 |