| NPI | 1871987875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 71293) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL 37524) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2024-07-02 |