| NPI | 1881006435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2018012696) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01078376) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2022-09-19 |